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Introduction
In 1994, Anne told me that
she was admitted to a mental hospital as a school
girl. She was often medicated with a major psychotropic
drug, Mellaril, and was also administered Electroconvulsive
Therapy. This affected her memory and her education.
She became a chronic psychiatric casualty who
is still chemically dependent today. Her sister
was placed in a Welfare institution and was
subjected to harsh treatment from big girls
of a different sexual orientation. Anne was
raped in the mental hospital while her sister
was bashed in the Welfare institution.
Many people have lived a life
of chronic disadvantage arising from the system
taking over and breaking families irreparably.
In the fifties, sixties and seventies there
was not much knowledge of the consequences and
deep injuries done to members of dysfunctional
families. Families that were cut adrift by the
system had children and adolescents sent to
foster homes, institutions or to mental hospitals.
Sexual abuse occurred, probably frequently.
One former female foster child told me in 1994
that she had been sexually abused in foster
care. Two men, Adrian and Peter recently told
me they had similar experiences in foster care.
Members of dysfunctional families
have always been of interest to Welfare and
Psychiatry. What is becoming apparent is that
many of their issues are social problems that
create burdens on the taxpayer, benefit dependency,
and much ill health in the face of health fund
cuts. Health cuts now ensure that only clearly
diagnosed people and substance abusers are treated
or hospitalized. The social problems now have
to be worked out with people who are not interested,
and often not knowledgeable about the issues.
One way to address social and family dysfunction
is through education - self-education for survivors
and also for the professional people who assist
survivors.
Some survivors, for example,
may experience repeated abuse, isolation and
witness threatening and intimidating behavior
of others. Oftentimes, other family members'
inappropriate behavior or reactions (e.g., they
blame the survivor for the abuse) heightens
traumatic reactions. The survivor may (if they
are lucky) be referred for professional help.
The casualties of families like this have been
described in submissions to the 1996 Mental
Health Inquiry. In the meantime, with limited
resources, some psychiatric and/or mental health
professionals will send the victims away and
say "Go back to your family." There
may be no family to return to! This is a social
problem and there are too many casualties in
New Zealand with issues still not properly resolved.
In the early 1990s, I addressed
Social Workers of the Children and Young Persons
Service. I told them that I often speculated
over whether or not some foster children were
being abused by their foster parents. A Social
Worker gave me vigorous nods from a back seat.
Children of abusive parents may be affected
by family dysfunction from the extended family
that became their foster family. As adults,
they are prone to becoming ill and have more
brushes with "the system." In many
cases their sense of self worth may be severely
knocked, and there are few reliable supportive
people in their environment.
Every survivor has good attributes
and qualities. They may have tremendous potential
but in difficult financial times, survivors
often do not have the money to develop that
potential. An adjunct Professor in Colorado,
Dr. Warner wrote that survivors of Schizophrenia
could recover in prosperous times. The same
is true of every other survivor in New Zealand.
In 1994, a Social Worker with
Children and Young Persons Service suggested
to me that long-term consequences of family
dysfunction were not the problem of their
department. An Income Support person told me
both branches kept on "passing the buck."
In 1995, I suggested to policy makers that they
bring parents into the campaign on prevention
of child abuse. The reply was that it "all
depended upon the allocation of resources."
In 1998, the Children and Young
Persons Service are now pushing to collaborate
with Health personnel. Public Health and the
Children and Young Persons Service in New Zealand
are affected by funding cuts. So problems of
dysfunction affect family members responsible
for people who have gone through the system.
Other victims are left to their own devices,
often in conditions of chronic disadvantage
and extreme poverty.
Posttraumatic Stress
Disorder
More knowledge has emerged
since the eighties in keeping with the policy
of emptying the mental hospitals; it was then
that Posttraumatic Stress Disorder (PTSD) entered
the diagnostic manual. This is a useful way
to understand the effects described above. A
significant and deleterious aspect of PTSD is
the train of thoughts associated with the violence
experienced by survivors at the hands of abusive
or hostile people. The traumatic thoughts may
haunt the sufferers for two decades or more.
The thoughts can also be accompanied by vivid
pictures behind the eyes of violent or vicious
people. These pictures are called "flashbacks."
Some sufferers never lose their traumatic thoughts
or the flashbacks. Pharmacology may aid in diminishing
certain symptoms, but there is still sound evidence
that mental health professionals often make
serious diagnostic errors regarding PTSD. Survivors
of PTSD may be misdiagnosed as Borderline Personality
Disorder and may be pressured to change their
behavior.
Some survivors, unable to stop
the flashbacks, may create different pictures.
Some may become sufficiently empowered to understand
that flashbacks are a symptom of Posttraumatic
Stress Disorder and effectively reduce or stop
them all together. Toxic psychiatry or ill-prescribed
drugs may exacerbate trauma reactions and at
times, contribute toward the experience of flashbacks.
Flashbacks can cause terror
and horror for survivors. It is comparable with
(and often confused with) the hallucinations
of Schizophrenia. Many women affected by PTSD
died at the hands of their violent spouses before
laws changed in the United States. Aphrodite
Matsakis, Ph.D. a specialist in PTSD wrote about
"Claudia" in Chapter Four of her book
I Can't Get Over It. Claudia was a
battered wife to whom the police said "There's
nothing we can do about it. Call us after he
actually starts beating or cutting you."
In the United States in the 1960s, a wife needed
consistent hospital reports for seven years
before she could win divorce on "battered
wife" grounds and a fair settlement. Claudia
did not win her divorce, her spouse did. Evidence
was given at the court that she had several
(unspecified) psychiatric disorders. She was
blamed for breaking up a happy home. Her spouse
won the home and left her in poverty. His victory
gave him authority to tell Claudia that he would
get the children if she could not support them.
Dr. Matsakis wondered whether Claudia's legal
counsel was incompetent, or whether there were
darker reasons that the personality of the abusive
spouse was not brought up in the divorce proceedings.
Dr. Matsakis writes that professionals
including doctors and nurses, at times, minimize
grievous losses. For example, after a Hurricane,
a concert violinist was taken to a makeshift
hospital along with others who were injured.
When she was told that three of her fingers
would have to be amputated, she began to cry.
Her nurse told her "Hush now, you big crybaby,
bed number one lost his arm and bed two has
to have both legs removed. Count your blessings
and don't upset the others." It is this
sort of indifference that must stop. If more
people including professionals hear the cries,
I believe that many of the tragedies (and potentially,
revictimization) could be stopped by a change
in direction from the policy makers.
Emotional Disorders
and Denial
New Zealand has been in denial
of the realities of social disadvantage for
many years. The denial is possibly an artifact
of people being frightened by what they can
not face in themselves. Victims of social casualties,
injustices, and massive losses are prevalent
in New Zealand society and survivors can and
will not go away.
One abused woman was told by
her divorced spouse that she could "crawl
off the face off the earth." This is indicative
of the way many people regard abused people,
who need to be heard and be assured that the
injustices will be addressed. If society, social
policy makers and the lawmakers do listen, the
pain may be slightly alleviated. Unfortunately,
many adhere to a "Just World" philosophy
(see the work of Janoff-Bulman). The basic assumption
of the "Just World" philosophy is
that if you are sufficiently careful, intelligent,
moral, or competent, you can avoid misfortune.
A Case Example from
Aotearoa, New Zealand
New Moon, a newsletter
put out by the Aotearoa Network of Psychiatric
Survivors, published an account in 1992 of a
woman, "Raelene," not being dealt
with appropriately or compassionately after
she was raped by an Island man in a mental hospital.
She was later cruelly manhandled by nurses when
she spoke about the rape at a group meeting.
The hospital people told the family an alleged
incident occurred. I met Raelene in 1994. She
was repeatedly committed through the testimony
of a nurse solely concerned with the behavior
and the symptoms. Raelene was trying to restore
the lost mobility of her left side. She had
to have several smaller meals in the course
of a day because of her stomach condition. Her
stomach bled from the drugs she was made to
take and the last time I saw her, she looked
very ill indeed.
Deinstitutionalization:
Human Rights or Financially Driven?
A few years ago, a nurse asked
me what I thought was the driving force behind
the emptying of the mental hospitals. I believe
that the policy is driven monetarily.
Dr. Jenkins, a United Kingdom doctor, attended
the 1993 mental health conference in Auckland.
He suggested that the proceeds from the sales
of hospitals should be put back into providing
services. This would ensure that deinstitutionalization
would be successful. Unfortunately, proceeds
of the sales of hospitals do not appear to have
been injected into community services.
Conclusion
Although more care with psychiatric
and abuse survivors is often taken today, not
all cases are successfully helped. My research
and experience in the first half of this decade
appears to be about abused rather than
mentally ill people, per se. Survivors' family
status is not always addressed by support workers,
although family status in the Human Rights legislation
must be adhered to. The Human Rights Act covers
situations such as employment, provision of
services, and accommodations on the grounds
of age, sexual status, health and family status.
Survivors are often held accountable
for the wrongdoing in their family. We must
remember that the problems of sexual abuse in
children, adolescents and adults as well as
the abuse sustained by the members of dysfunctional
families are very serious. Theses difficulties
are quite prevalent. The issues often appear
to be swept under the carpet. Sadly, misdiagnosed
survivors are often ridiculed or stigmatized
by many people which perpetuates their social
disadvantage.
©1998 by
The American Academy of Experts in Traumatic
Stress, Inc. |
